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"The way the body metabolizes a commonly prescribed anti-retroviral drug that is used long term by patients infected with HIV may contribute to cognitive impairment by damaging nerve cells, a new Johns Hopkins research suggests.

Nearly 50 percent of people infected with HIV will eventually develop some form of brain damage that, while mild, can affect the ability to drive, work or participate in many daily activities. It has long been assumed that the disease was causing the damage, but Hopkins researchers say the drug efavirenz may play a key role.

People infected with HIV typically take a cocktail of medications to suppress the virus, and many will take the drugs for decades. Efavirenz is known to be very good at controlling the virus and is one of the few that crosses the blood-brain barrier and can target potential reservoirs of virus in the brain. Doctors have long believed that it might be possible to alleviate cognitive impairment associated with HIV by getting more drugs into the brain, but researchers say more caution is needed because there may be long-term effects of these drugs on the brain....."

Happy camper here after making the switch from Atripla to Complera.There were a few instances earlier this year when I was beginning to think about moving to Shady Groves lol. Anqueetas---glad to hear you are doing well too.....

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I may not agree with you, but will always defend your right to disagree.

i have been on Atripla since 2006 and have noticed a slow but steady decline with my memory. made a turkey meatloaf yesterday afternoon in my toaster oven (with auto-shutoff feature) to have for dinner tonight. remembered that i didn't take it out of the oven at 5 AM.

^this was just the latest of my many brain fog fun mishaps.

spoke to my ID doc about making a med change. he is going to send me a list of my best options and by my next visit in february, hope to get off of atripla.not looking forward to getting used to another set of side effects, but hope they will be minor and short lived.

@Mitch777.......even with auto shut-off feature that was truly a salmonella-free turkey meatloaf. Hats off to you.....lots of respect for anyone that has lived 30 years with HIV.I know you had plenty of dark days in the 80's/90's.Best of luck with your 2013 meds change.

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I may not agree with you, but will always defend your right to disagree.

Don't forget to turn the oven on. Thanks to my many years of brain destroying meds, I'm left with the ability to do some of the dumbest shit. Especially misplacing things. Have found my cell phone in the freezer and my wallet in the fridge.

I noticed marked decline during my Sustive period. Driving was next to impossible as I couldn't comprehend all the combined needs of driving safely.

I guess it's a wait and see for us long termers to see how this all plays out in the later years. Could you imagine being in a nursing home with the likes of MissP?

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Complacency is the enemy. Challenge yourself daily for maximum return on investment.

Curious, since I am on Atripla but have not experienced any memory issues. In fact, prior to going on meds I noticed some "brain fog" but once I started meds it resolved.

How long was it, that you were on Atripla (or Sustiva) that you noticed any sort of memory decline? Was it gradual over time or more immediate. Do you really think it was attributed to Atripla and if so when/if you changed medications did it resolve?

For those of us on Atripla and doing otherwise ok, maybe some advice or warning signs that we should be cognisant of?

Hi Bug ... Although you didn't ask the question of me I thought I would chime in .

I have been on Atripla since it was available but its just the last 4 years where I have noticed my memory slipping . I talked to me doctor about it and she reminded me that at my age , its the time you begin to see a mild decline in memory .

I used to know where everything in my house was , now I have to go look . Last I accidentally took a shot of insulin twice and had a low blood sugar episode that scared the crap out of me . I'm glad we are discussing this , I'm not sure in my case if its meds or that I'm getting older . It also worries me because my mom has Alzheimer's , and dementia runs in my family .

Don't forget to turn the oven on. Thanks to my many years of brain destroying meds, I'm left with the ability to do some of the dumbest shit. Especially misplacing things. Have found my cell phone in the freezer and my wallet in the fridge.

I noticed marked decline during my Sustive period. Driving was next to impossible as I couldn't comprehend all the combined needs of driving safely.

I guess it's a wait and see for us long termers to see how this all plays out in the later years. Could you imagine being in a nursing home with the likes of MissP?

Hi Bug ... Although you didn't ask the question of me I thought I would chime in .

I have been on Atripla since it was available but its just the last 4 years where I have noticed my memory slipping . I talked to me doctor about it and she reminded me that at my age , its the time you begin to see a mild decline in memory .

I used to know where everything in my house was , now I have to go look . Last I accidentally took a shot of insulin twice and had a low blood sugar episode that scared the crap out of me . I'm glad we are discussing this , I'm not sure in my case if its meds or that I'm getting older . It also worries me because my mom has Alzheimer's , and dementia runs in my family .

jg,

i could have posted almost the same post (excluding the blood sugar episode).mom with alz, almost the same age (almost...grrr... )meds or older question.

and also think this needs to be discussed more.

i think this topic might get more exposure if it were moved because, quite frankly, it took me forever to remember where it first began.HELP Ann and Andy!

"...health will finally be seen not as a blessing to be wished for, but as a human right to be fought for." Kofi Annan

Nymphomaniac: a woman as obsessed with sex as an average man. Mignon McLaughlin

HIV is certainly character-building. It's made me see all of the shallow things we cling to, like ego and vanity. Of course, I'd rather have a few more T-cells and a little less character. Randy Shilts

I have taken 400 mg (low dose) Sustiva daily for over 12 years with no decline in memory or cognitive abilities.

I have, of late however, had a few sligthly pronounced melancholy episodes. Some of the episodes were tied to stressful situations which I am addressing.

That's the great thing about having different med options. Sustiva was destroying my mental capabilities yet when I switched to Isentress, Truvada and Intellence the issues subsided. I've noticed a marked improvement in my cognitive ability of late. Perhaps it's the crutches thingy and the need to focus?

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Complacency is the enemy. Challenge yourself daily for maximum return on investment.

I don't take Efavirenz and my memory is really bad. I take Truvada and Isentress.

I am glad to hear you say this because I am also experiencing cognitive problems of a wide variety. Not severe impairment, but the "I have a little voice inside that is telling me this isn't right" level of wrong. It's getting unnerving lately.

I also do not take sustiva, but do take truvada - along with prezista and a norvir chaser.

It ranges everywhere from marked memory loss to constant wire crossing. I am finding it harder to type and write. I make the same mistakes repeatedly - like I try to correct it and write the same incorrect thing. It made me think of something like dyslexia or something. Trouble concentrating. All that mess. It isn't fun in the least.

I used to type really fast. You'd be suprised how much slower it was for me to type this and how many mistakes I had to correct multiple times. At least I can still tell when something IS incorrect.

I noticed memory problem almost as soon as I started taking it... It is really worst if I´m under stress because of work or when I´m tired and sleep bad. It is a problem at work because I have some responsabilities and I sometimes forget important meetings or events... I´m also less less patient than before, I don´t know if it is for the drugs or other "problems" in my life, lack of holidays...

In the country where I live, I actually don´t have any other option than Efavirenz (Sustiva) ; anyway, in regard to HIV itself, I consider that these side effects are completely not so hard to deal with... I hope we will soon have some more option at god price here...